Thursday, March 5, 2009
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ONLINE EXCLUSIVE
Panel: 'Food Fight' Possible On Cost Of Health Reform
An Expert Panel Discusses The Future Of A Universal Health Coverage Mandate And Ways To Cut Reform Costs
Reforming the U.S. health care system will be frustrating and costly, but it will have to be high on the government's agenda, according to an expert panel assembled this morning as part of National Journal's Policy Breakfast series.
The panel, which included Republican Sen. Robert Bennett of Utah and SEIU President Andy Stern, spoke with Atlantic Media Co. Political Director Ronald Brownstein and National Journal staff correspondent Marilyn Werber Serafini today in Washington about how President Obama and the Democrats can pay for the far-reaching reforms they've proposed.
The current health care system will need comprehensive reform, said Liz Fowler, senior counsel to Senate Finance Committee Chairman Max Baucus, D-Mont., who released his own health reform plan last November and is positioned to oversee reform efforts in the Senate. The panelists all voiced support for Fowler's three core principles of any future overhaul: providing universal coverage, increasing quality of the care and blocking its rising cost. And they agreed fundamental changes would be necessary.
"We cover everyone now -- let's look at the reality. It's just done in the most stupid, ineffective way," said Bennett, who together with Sen. Ron Wyden, D-Ore., has been leading a bipartisan coalition of 13 senators proposing a bill to guarantee health care to every American.
More Republicans are coming around to the idea of universal health care, Bennett said, but it will be an ideological dealbreaker for them if it becomes a "pathway to single-payer, government-run" system.
America's Health Insurance Plans, an industry trade association, has likewise warmed to reform efforts. Last December, the group issued its own plan, which included calls for an individual coverage mandate. When asked about the measure, AHIP President and CEO Karen Ignagni said the requirement would send a clear signal to the American people. "The public is telegraphing they don't want a system where people are falling through the cracks and can't pay for health care," she said, adding that government needed to consider the balance between private and public sectors' responsibilities.
Stern, the Service Employees International Union president, said one of the key concepts of reforming the industry should be a shift from the "sick care" paradigm to one of continuous health care that would include more preventative medicine. "In the end," he added, "you can't have a system if you don't have everyone in," so he would support an individual mandate, something Fowler soon echoed in her answer.
So, how can the government ensure affordable universal health care without attaching a heavy price tag to the budget? The U.S. already spends about $2.5 trillion annually on health care, and Obama allocated $634 billion in his 2010 budget blueprint for reform efforts. All four panelists agreed that cost will ultimately be the deciding factor on what kind of reforms are passed, and how to pay for reforms will spark many debates.
"The best cost control is quality," Bennett said. "We have more than enough to provide intelligent health care. We're just doing it the wrong way." Citing communities like Seattle, Salt Lake City and Rochester, Minn., as examples of affordable and high-quality health care systems, Bennett said a change of provider incentives, tax law and regulations would go far to lower costs.
Health care should be portable, Bennett went on to argue, receiving hearty agreement from Fowler. At least one lesson learned from the Clinton administration's reform efforts, Fowler said, is that "people who are happy with their coverage want to keep it," so upsetting the current system too much could lead to a disastrous public response.
When Brownstein asked whether budget-neutral financing -- something Baucus raised this week (subscription) -- would win over Republicans, Bennett said he couldn't speak for all party members, but "if it takes $634 billion to break the present paradigm and get us where we need to be -- I'll be willing to look at it."
The key issue, Stern said, was that it's not up to the committees and legislators alone to decide the future of the U.S. health care system, repeating one of Ignagni's main points of the morning. Stakeholders must "come to the table with solutions," and unless they come up with some new ideas, "we'll end up in a traditional Washington food fight over cost containment."